Paying for quality

AHIP: Hospital rewards, education help curb infections

Topics: Finance, Reimbursement, Infection Control, Quality, Performance Improvement

August 31, 2011

Providing hospitals incentives to improve hygiene practices and boost safety education can lead to fewer infections, according to a new report by America's Health Insurance Plans (AHIP).

The report outlines several insurer reward programs that led to improved patient outcomes at hospitals. For example, one program—administered by BlueCross BlueShield (BCBS) of Tennessee—rewards health care providers for meeting certain quality goals.

Overall, the program thus far has reduced central-line associated bloodstream infections by 40%, preventing 296 infections at 60 hospitals between 2007 and 2008. According to a BCBS of Tennessee spokesperson, the program saved 35 lives, 4,973 hospital days, and $7.5 million in costs.

Another program outlined in the report involved Virginia-based Sentara Healthcare and Optima Health. Under the initiative, Optima pays bonuses to hospitals that successfully reduce facility-acquired urinary-tract infections, hospital-acquired pressure ulcers, patient falls, and myocardial infarctions. Hospitals that have no death or injury incidents are eligible to receive extra bonuses, National Journal reports.

According to Optima, the program reduced ventilator-associated pneumonia cases by 97% and central-line associated bloodstream infections by 91% between 2002 and 2011 (Fox, National Journal, 8/29 [subscription required]).

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